Choline Deficiency Is a Thing. Here’s Why You Need It

When my wife Lana and I were ready to become parents, we did tons of research on pregnancy and early childhood. I wanted to give my kids the best start, and I especially wanted to make sure that their brains would grow as strong as they possibly could. The fastest growth phase the brain goes through happens from conception through age 3.

The baby and toddler years are the critical period to give your child the nutrients and energy that the brain needs for development. That’s when I started paying attention to choline, since choline is vital to early brain development.^[1]

The more I read about it, the more I understood that it’s for grown-ups, too — for things like muscle control, metabolism, liver health and so much more.

If you’ve ever experienced brain fog, muscle twitching, trouble with attention or learning, unpredictable moods, or nerve tingling, you might need more choline. Keep reading to find out what choline does, and whether or not you need a choline supplement.

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What is choline?

You could say that choline has a history of an identity crisis.

Is choline essential? Until recently, choline was considered a non-essential nutrient because the human body makes it. Since the late 1990s, researchers have agreed that choline is an essential nutrient because you don’t make enough to meet your needs, and you have to make up the difference with food or supplements.^[2]

Is choline a vitamin? Choline’s activity is certainly vitamin-like — it’s so similar to the B vitamins that manufacturers often include it in B complex formulas and prenatal vitamins. But, scientists haven’t officially labeled choline as a vitamin because researchers have not yet established deficiency criteria for humans.

So, what is choline? In short, it’s a nutrient that’s crucial to your body’s function, and you have to get it from outside sources to get enough.

What does choline do?

Choline is unique in that it is indispensable for many processes in the body that are seemingly unrelated to each other. Here are a few functions that involve choline:

Choline helps babies develop

Choline is involved in several vital body processes, starting with your development as a fetus. Prenatal vitamins usually contain choline because it is critical for healthy fetal development, especially the brain and nervous system.^[3]

Choline grows strong cell membranes

Choline is a vital component of phospholipids, which make up cell membranes. You want strong cell membranes so that your cells are resistant to damage, and so that individual cells perform their functions more effectively.

Choline helps you use fat effectively

Another function of choline is fat transport. Choline has a crucial role in bringing fats out of the liver^[4] for your body to use. You need your body to be able to take fats out of the liver and send it into the bloodstream so that your body can use it for energy, to help absorb fat-soluble nutrients, and to make brain components such as myelin. On the flipside, if fat stays in the liver, you end up with fatty liver disease, which can cause pain, enlargement of the liver, extreme fatigue, and toxic overload.

Choline and methylation

Choline is also involved in methylation, the part of metabolism that helps your body:

• Produce and repair DNA
• Detox
• Regulate histamine
• Support eye health
• Fuel your cells

High-dose choline reduced DNA damage in men with methylation problems.^[5]

Choline and muscle control

Choline is the building block for acetylcholine, a chemical messenger between your nerves and muscles that tells your muscles when to activate. Acetylcholine deficiency can have severe effects — for example, medicines that disrupt this pathway can cause muscle spasms, irregular heartbeat, and even paralysis.

Choline and the brain

Choline is a nootropic — a supplement that enhances cognitive function. Since you use so much acetylcholine when you’re calculating, processing, and problem-solving, having enough choline means having the acetylcholine you need^[6] for attention and focus.^[7] Bonus: more choline available to your brain means less brain inflammation, which is great for learning, memory, focus, and mood.^[8]

How much choline do you need?

Choline needs vary from person-to-person, and how much you need depends on genetics, gender, and environmental factors.^[9] The National Academy of Medicine, a non-profit that provides scientific and policy advice on human health, recommends:

Age	Intake	Upper Limit
Infants 0-6 mo Infants 6-12 mo   1-3 years 4-8 years 9-13 years   Men 14-18 years Men >18 years   Women 14-18 years Women >18 years   Pregnant women Lactating women	125 mg/d, 18 mg/kg 150 mg/d   More Supplements From Bulletproof Zinc Benefits Immunity, Plus Other Reasons to Take a Zinc Supplement How to Stay Focused When You’re Working from Home What Is Bioavailability? How to Make Sure Your Supplements Actually Work 9 Supplements to Reduce Stress (Especially Now) 200 mg/d 250 mg/d 375 mg/d   550 mg/d 550 mg/d   400 mg/d 425 mg/d   450 mg/d 550 mg/d	not established not established   1000 mg/d 1000 mg/d 2000 mg/d   3000 mg/d 3500 mg/d   3000 mg/d 3500 mg/d   Age-appropriate upper limit Age-appropriate upper limit

Choline deficiency symptoms

You might be deficient in choline if you experience things like:

• Ongoing tiredness or fatigue
• Reduced ability to think things through or problem solve
• Difficulty picking up new information
• Emotional swings or mood disorders
• Memory trouble
• Muscle aches
• Nerve pain or tingling

Choline deficiency and fatty liver disease

Since choline has such a critical role in fat transport, when there’s not enough, fat can stagnate in the liver and cause fatty liver disease. Doctors were able to reverse TPN associated fatty liver disease (TPN stands for total parenteral nutrition, which means getting 100% of your nutrition by an IV drip) in patients just by adding 2g of choline to their feeding formula.

What foods are high in choline

You can supplement, but you can get the choline you need if you eat high-choline foods regularly. Make sure a variety of the following foods make it into your shopping cart every time:

• Beef liver
• Eggs
• Beef
• Brussels sprouts
• Broccoli
• High-quality wild-caught fish and shellfish (tuna, salmon, scallop)
• Cauliflower
• Peas
• Cabbage
• Carrots
• Kiwifruit

Another source of choline is sunflower lecithin, which provides phosphatidylcholine that breaks down into choline. You can take sunflower lecithin in a capsule or blend the powder into smoothies, your Bulletproof Coffee, or mix it into your “Get Some Ice Cream” recipe.

How much choline is too much? You’re not likely to go overboard with food, but if you’re overdoing the choline supplements, you’ll know. Excess choline causes a buildup of trimethylamine, which makes your skin smell like leftover salmon.

Make it a priority to get a minimum of 4-5 servings of high-choline foods per week, and before you supplement, check your combination supplements and nootropic stacks for choline on the nutrition label. You may be taking choline already without realizing it.

Read next: Brain Food: 5 Nutrients That Upgrade Your Mind